Abstract: Objective: To investigate the results of the operative treatment of Pilon fracture by using the external fixation and compare the results with internal fixation. Methods: Thirty-six patients with Pilon fractures were treated with single arm-three-diementionl external fixator or T shape basitinni external fixator as shaft axial fixation or tibial supportive plate or AO three-leaves plate and simple internal fixation of the fibula to restore anatomical reduction of the ankle. Results: All the patients were followed up for 4 to 60 months. All fractures were united according to the Mazur scoring system and the excellent and good rate was 75%. Conclusions: External fixation with limited internal of Pilon fractures has such advantages as simple operative technique, less injuries, anatomic reduction of ankle, earlier rehabilitation and satisfactory functional recovery.